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27 Jul 2023

Experts fear spike in liver cancer cases following decline in hepatitis testing

Cancer Council Victoria is urging the Victorian community and clinicians to push for more testing after new data from the Peter Doherty Institute for Infection and Immunity (Doherty Institute) revealed a staggering 20,700 Victorians may unknowingly be living with hepatitis B, increasing their risk of liver cancer. 

The Doherty Institute’s Viral Hepatitis Mapping Project¹ also reported an alarming 18.2 per cent decrease in the number of hepatitis serology tests between 2020 and 2022 in Victoria. Hepatitis B and C account for most cases of liver cancer in Australia and globally, and can be diagnosed with a simple blood test – although many people with hepatitis B remain untested and unaware. 

The Royal Melbourne Hospital’s Professor Benjamin Cowie, Director of the WHO Collaborating Centre for Viral Hepatitis at the Doherty Institute, said with early detection and regular monitoring, Victorians living with hepatitis B could prevent progression to liver cancer. 

“An unacceptable number of people living with hepatitis B are still diagnosed too late - sometimes at the same time or even after a liver cancer diagnosis. Tragically, most of these cancers would have been prevented if the person was diagnosed earlier and received appropriate treatment and care. We have had simple blood tests for hepatitis B for over 50 years,” Professor Cowie said. 

“Australia’s low progress in scaling up diagnosis, care and treatment for hepatitis B is costing lives due to liver cancer. We must urgently act to save these lives lost to a preventable cancer. 

“It’s important that Victorians are diagnosed with hepatitis to ensure health professionals can provide appropriate monitoring and treatment as this is one of the best preventative actions against liver cancer.” 

Liver cancer is the sixth most common cause of cancer-related death in Victoria, with 427 Victorians losing their life as a result of the disease in 2021². 

Cancer Council Victoria Chief Executive Officer Todd Harper AM said it was imperative this message was shared throughout Victoria as liver cancer often had few or no symptoms and was often detected when treatment or liver transplant was no longer an option. 

“Alarmingly the rate of people losing their life to liver cancer is growing faster than any other type of cancer Australia³,” Mr Harper said. 

“There are many reasons why we’ve seen a decline in testing and we know people’s attitudes towards health appointments have changed over the last few years due to the pandemic. But now it’s time to get back on track and talk to your GP about hepatitis.” 

Many people incorrectly presume alcohol consumption is the only cause of liver cancer. In fact, most people acquire hepatitis B at birth or in early childhood. 

People are more at-risk if they were born in hepatitis B endemic regions with limited or no access to vaccines, including parts of East and Southeast Asia, Pacific Island countries, parts of central Asia, the Middle East, the Amazon Basin and sub-Saharan Africa⁴.

Nafisa Yussf immigrated to Australia from Somalia and after experiencing headaches, dizziness, and nausea, spoke to a doctor and was tested for hepatitis. 

Nafisa Yussf, co-founder and chair of Hepatitis B Voices Australia
Nafisa Yussf, co-founder and chair of Hepatitis B Voices Australia

“I was a recent arrival in Australia when I was diagnosed. I didn’t speak English well, and I didn’t know anyone else living with hepatitis B at the time,” Ms Yussef said. 

“I’ve lived with a hepatitis B diagnosis for over 15 years and learnt a lot about how different people’s treatment and management is, I’ve been able to manage my diagnosis with daily medication and regular check-ups.” 

As co-founder and chair of Hepatitis B Voices Australia, Ms Yussef has worked to support other new arrivals and families who are at risk of hepatitis B, which includes destigmatising the virus. 

“Hepatitis B is intergenerational which impacts the whole family with generations of people living and dying of liver cancer – this trauma can echo through many family generations but can be stopped if we get more people tested and educated about the disease,” Ms Yussef said. 

To find out more about the links between hepatitis B and liver cancer, visit the hepatitis B and liver cancer webpage on the Cancer Council Victoria website

¹MacLachlan JH, Romero N, Purcell I, Cowie BC. Viral Hepatitis Mapping Project: Hepatitis B. National Report 2021. Darlinghurst, NSW: Australasian Society for HIV, Viral Hepatitis, and Sexual Health Medicine (ASHM), 2023.  

²Victorian Cancer Registry. Cancer in Victoria Report, 2021. Cancer Council Victoria, 2022.  

³Cancer Council Australia. (2023). Roadmap to Liver Cancer Control in Australia. Sydney: Cancer Council Australia.